How Likely Are Hollow Eye Sockets Following Asian Eyelid Surgery?

Fat is usually not removed as part of Asian eyelid surgery. Sometimes I see hollowness from ptosis which becomes more obvious after surgery and causes the brow to be recruited upward. The situation improves as the swelling comes down.

In general, no fat needs to be removed when performing Asian eyelid surgery.  The goal of surgery is creation of a double fold.  The goal is not depleting fat from the upper eyelids.  The depleted upper eyelid hollow can be hastened with over aggressive eyelids surgery.  However, some individuals and families are prone to developing this type of change as they age irrespective of their surgical history.

Hollowness of the eye sockets after Asian eyelid blepharoplasty can occur, especially if the surgeon is not familiar with Asian blepharoplasty.  The important thing is to not remove fat.  If you remove fat, hollowness can occur.

As a rule you want to conserve fat of the upper eyelid in and asian patient, especially in a younger patient.  You may win yourself an eyelid that looks great and a little less full by taking fat when you're 25 years old but it's not so cute when you're 40 and have hollow eyes.  Reversal of this issue is a procedure I perform in my practice on patients who have had their original surgery else where 5 to 20 years ago.  It works well but isn't always perfect so the rule is. . .SAVE THE FAT  or the very least be concervative.

This does depend on your age to some degree.  Here are some scenarios.

1.  You're young and you want a more visible crease or to create a double eyelid.  Save the fat.  It's all about proper technique with an experienced surgeon.

2.  You're approaching your 50's or older and you want to reduce fullness and excess skin of the upper lid.  You carefully and strategically remove or reduce fat, but still don't remove it all.  As we age the wall that holds the fat back (the septum) weakens and allows a little fat to move forward.  Just reduce it or push the fat back a bit.

If your surgeon insists significant fat be removed get a second opinion.

 

Hope that helps.

Dr. Chase Lay

This is often caused from overresection of fat in the eyelids.  Even up to a few years ago, the conception was that excess fat gave an older appearance.  However, now the thinking has changed into fat preservation.  With Asian eyelids, depending on the amount of fat in the upper eyelid, some fat may need to be removed, but excess removal will cause unwanted hollowness which can contribute to an aged appearance.  This is unlikely to result if you go to someone who is a specialist with Asian eyelids.